Access and Wait Times: A Geographic Exploration of Diagnostic Imaging in Ontario

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Abstract

Diagnostic imaging plays a crucial role in frontline health care, providing the information some physicians need to make a diagnosis and determine a course of treatment. Delays in access not only lead to undue stress for patients who are not sick but can postpone treatment for those who are. The issue of lengthy wait times in Canada, in particular, is both socially and politically charged, as “waiting lists” are typically viewed as a proxy for access to care. The topic is widely reported in mainstream media and has been targeted by both federal and provincial governments.
Using data from the Canadian Community Health Survey – Annual Component, 2010 and the Ministry of Health and Long-Term Care, this thesis aimed to provide a holistic understanding of the accessibility of diagnostic imaging in the context of Ontario, with specific attention given to the role of wait times. IBM SPSS 24.0 was used to perform cross-tabulations, chi-square tests of independence and run a binary logistic regression model, while geographic analysis was performed using Esri’s ArcMap software.
Waiting too long was cited as the top barrier to access for diagnostic services, with worry, stress and anxiety being the main impact associated with waiting. Differences in the types of difficulties and impacts of waiting were observed based on population characteristics. Wait time acceptability differed depending on difficulty with access and was shown to influence one’s rating of broader health services. Most respondents reported that their wait time was acceptable, regardless of geography. That said, wait times for MRI services were variable throughout the province. Average provincial wait times increased between January 2014 and December 2016 and did not meet the 28-day target at any point throughout the study period.
This research suggests that while wait times should remain an important government priority, there is a need for more targeted interventions that take into account patient experience from a broad perspective. Simply increasing the capacity available to perform diagnostic services has not proven to be a sufficient strategy. Future research can help inform this policy direction by employing more comprehensive methodologies that critically engage with patient perceptions.